Beach, Larry Leon

Beach, Larry Leon is an individual health care provider with primary practice located at 3915 Talbot Rd S Suite 209, Renton WA 98055-5738. He recently has only one registered license in Eye and Vision Services Providers / Corneal and Contact Management, which is considered as his primary health care specialty. Beach, Larry Leon can be contacted via phone (425) 235-9911.

Contact Information

Primary practice address
3915 Talbot Rd S Suite 209 Renton WA 98055-5738
Fax: (425) 254-8807
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Corneal and Contact Management 152WC0802X OD00001150 Washington

Profile Details

NPI number 1306882600
LBN Legal business name Beach, Larry Leon
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2006
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306882600 NPPES
Washington MEDICAID 2025096

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